Casapía Martin, Joseph Serene A, Núñez Carmen, Rahme Elham, Gyorkos Theresa W
Asociación Civil Selva Amazónica, Urbanización Jardin 27, Iquitos, Peru.
Br J Nutr. 2007 Dec;98(6):1259-66. doi: 10.1017/S0007114507795272. Epub 2007 Jul 26.
Child malnutrition, including wasting, underweight and stunting, is associated with infections, poor nutrient intake, and environmental and socio-demographic factors. Preschool-age children are especially vulnerable due to their high growth requirements. To target interventions for preschool-age children in a community of extreme poverty in Peru, we conducted a household survey between October 2005 and January 2006 to determine the prevalence of malnutrition and its risk factors. Of 252 children < 5 years old, the prevalence of wasting, underweight and stunting was 26.6, 28.6 and 32.1 %, respectively, based on the new WHO Child Growth Standards. Risk factors for wasting were: (1) moderate-high intensity Trichuris infection (OR 2.50; 95 % CI 1.06, 5.93); (2) hookworm infection (OR 6.67; 95 % CI 1.08, 41.05); (3) age (OR6-month 1.27; 95 % CI 1.11, 1.46); (4) maternal education (secondary incomplete) (OR 5.77; 95 % CI 2.38, 13.99); and (5) decreasing maternal BMI (OR1 kg/m2 1.12; 95 % CI 1.02, 1.23). Risk factors for underweight were: (1) moderate-high intensity Trichuris infection (OR 4.74; 95 % CI 1.99, 11.32); (2) age (OR6-month 1.22; 95 % CI 1.07, 1.38); (3) maternal education (secondary incomplete) (OR 2.92; 95 % CI 1.40, 6.12); and (4) decreasing maternal BMI (OR1 kg/m2 1.11; 95 % CI 1.02, 1.21). Risk factors for stunting were: (1) age (OR6-month 1.14; 95 % CI 1.02, 1.27) and (2) decreasing maternal height (OR1 cm 1.12; 95 % CI 1.06, 1.20). Overall, risk factors for malnutrition included both child and maternal determinants. Based on these data, locally appropriate and cost-effective dietary, de-worming and educational programmes should be targeted to mothers and preschool-age children.
儿童营养不良,包括消瘦、体重不足和发育迟缓,与感染、营养摄入不足以及环境和社会人口因素有关。学龄前儿童因其高生长需求而特别脆弱。为了针对秘鲁一个极端贫困社区的学龄前儿童开展干预措施,我们在2005年10月至2006年1月期间进行了一项家庭调查,以确定营养不良的患病率及其风险因素。在252名5岁以下儿童中,根据世界卫生组织新的儿童生长标准,消瘦、体重不足和发育迟缓的患病率分别为26.6%、28.6%和32.1%。消瘦的风险因素包括:(1)中高强度鞭虫感染(比值比2.50;95%置信区间1.06,5.93);(2)钩虫感染(比值比6.67;95%置信区间1.08,41.05);(3)年龄(每6个月比值比1.27;95%置信区间1.11,1.46);(4)母亲教育程度(初中未毕业)(比值比5.77;95%置信区间2.38,13.99);以及(5)母亲体重指数下降(每1kg/m²比值比1.12;95%置信区间1.02,1.23)。体重不足的风险因素包括:(1)中高强度鞭虫感染(比值比4.74;95%置信区间1.99,11.32);(2)年龄(每6个月比值比1.22;95%置信区间1.07,1.38);(3)母亲教育程度(初中未毕业)(比值比2.92;95%置信区间1.40,6.12);以及(4)母亲体重指数下降(每1kg/m²比值比1.11;95%置信区间1.02,1.21)。发育迟缓的风险因素包括:(1)年龄(每6个月比值比1.14;95%置信区间1.02,1.27)和(2)母亲身高下降(每1cm比值比1.12;95%置信区间1.06,1.20)。总体而言,营养不良的风险因素包括儿童和母亲两方面的决定因素。基于这些数据,应针对母亲和学龄前儿童开展适合当地情况且具有成本效益的饮食、驱虫和教育项目。